{"title":"意识障碍的定义、诊断标准和临床评估量表。","authors":"Bei Zhang, Nathan Darji, Joseph T Giacino","doi":"10.1016/B978-0-443-13408-1.00011-7","DOIUrl":null,"url":null,"abstract":"<p><p>Disorders of consciousness (DoC) are neurologic conditions characterized by severe alteration in level of consciousness. Categories of DoC may include coma, unresponsive wakefulness syndrome/vegetative state, minimally conscious state (MCS; can be further categorized into MCS+ and MCS- based on the presence or absence of language-related behaviors), emergence from MCS, confusional state or delirium, and cognitive motor dissociation (CMD). CMD is a recently defined condition in which the patient fails to demonstrate observable behavioral responses on bedside assessment but demonstrates covert cognitive processing on functional imaging or EEG studies. Accurate differential diagnosis in DoC is aided by adherence to basic principles of assessment, including use of standardized assessment scales. Clinicians should serially administer standardized assessment tools to ensure valid interpretation of results and optimize diagnostic accuracy. Among standardized scales, the Coma Recovery Scale-Revised is most widely used and has the strongest psychometric validity in assessing DoC. The Neurocritical Care Society's Curing Coma Campaign has proposed a slate of DoC common data elements that is expected to improve the consistency and precision of DoC research.</p>","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"207 ","pages":"1-13"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Definitions, diagnostic criteria, and clinical assessment scales in disorders of consciousness.\",\"authors\":\"Bei Zhang, Nathan Darji, Joseph T Giacino\",\"doi\":\"10.1016/B978-0-443-13408-1.00011-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Disorders of consciousness (DoC) are neurologic conditions characterized by severe alteration in level of consciousness. Categories of DoC may include coma, unresponsive wakefulness syndrome/vegetative state, minimally conscious state (MCS; can be further categorized into MCS+ and MCS- based on the presence or absence of language-related behaviors), emergence from MCS, confusional state or delirium, and cognitive motor dissociation (CMD). CMD is a recently defined condition in which the patient fails to demonstrate observable behavioral responses on bedside assessment but demonstrates covert cognitive processing on functional imaging or EEG studies. Accurate differential diagnosis in DoC is aided by adherence to basic principles of assessment, including use of standardized assessment scales. Clinicians should serially administer standardized assessment tools to ensure valid interpretation of results and optimize diagnostic accuracy. Among standardized scales, the Coma Recovery Scale-Revised is most widely used and has the strongest psychometric validity in assessing DoC. The Neurocritical Care Society's Curing Coma Campaign has proposed a slate of DoC common data elements that is expected to improve the consistency and precision of DoC research.</p>\",\"PeriodicalId\":12907,\"journal\":{\"name\":\"Handbook of clinical neurology\",\"volume\":\"207 \",\"pages\":\"1-13\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Handbook of clinical neurology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/B978-0-443-13408-1.00011-7\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Handbook of clinical neurology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/B978-0-443-13408-1.00011-7","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
Definitions, diagnostic criteria, and clinical assessment scales in disorders of consciousness.
Disorders of consciousness (DoC) are neurologic conditions characterized by severe alteration in level of consciousness. Categories of DoC may include coma, unresponsive wakefulness syndrome/vegetative state, minimally conscious state (MCS; can be further categorized into MCS+ and MCS- based on the presence or absence of language-related behaviors), emergence from MCS, confusional state or delirium, and cognitive motor dissociation (CMD). CMD is a recently defined condition in which the patient fails to demonstrate observable behavioral responses on bedside assessment but demonstrates covert cognitive processing on functional imaging or EEG studies. Accurate differential diagnosis in DoC is aided by adherence to basic principles of assessment, including use of standardized assessment scales. Clinicians should serially administer standardized assessment tools to ensure valid interpretation of results and optimize diagnostic accuracy. Among standardized scales, the Coma Recovery Scale-Revised is most widely used and has the strongest psychometric validity in assessing DoC. The Neurocritical Care Society's Curing Coma Campaign has proposed a slate of DoC common data elements that is expected to improve the consistency and precision of DoC research.
期刊介绍：
The Handbook of Clinical Neurology (HCN) was originally conceived and edited by Pierre Vinken and George Bruyn as a prestigious, multivolume reference work that would cover all the disorders encountered by clinicians and researchers engaged in neurology and allied fields. The first series of the Handbook (Volumes 1-44) was published between 1968 and 1982 and was followed by a second series (Volumes 45-78), guided by the same editors, which concluded in 2002. By that time, the Handbook had come to represent one of the largest scientific works ever published. In 2002, Professors Michael J. Aminoff, François Boller, and Dick F. Swaab took on the responsibility of supervising the third (current) series, the first volumes of which published in 2003. They have designed this series to encompass both clinical neurology and also the basic and clinical neurosciences that are its underpinning. Given the enormity and complexity of the accumulating literature, it is almost impossible to keep abreast of developments in the field, thus providing the raison d''être for the series. The series will thus appeal to clinicians and investigators alike, providing to each an added dimension. Now, more than 140 volumes after it began, the Handbook of Clinical Neurology series has an unparalleled reputation for providing the latest information on fundamental research on the operation of the nervous system in health and disease, comprehensive clinical information on neurological and related disorders, and up-to-date treatment protocols.
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